The Longitudinal Impact Of A Multistate Commercial Accountable Care Program On Cost, Use, And Quality.

The prevalence of accountable care organizations (ACOs) has grown significantly across Medicare and commercial payers in the past decade, but there are limited insights regarding the effect of ACOs on costs in the commercial population. We used longitudinal administrative claims data over the course of nineteen calendar quarters from 2016 to 2021 to assess the ongoing incremental impact of Elevance Health's commercial ACO program on cost and use across fifteen US states. We also analyzed the program's impact on spending subcategories (inpatient, outpatient, professional, and pharmacy) and measured differences in quality performance.

The impact of a retail prescription synchronization program on medication adherence.

Objectives: To understand the impact of prescription synchronization, offered through the ScriptSync® program at CVS pharmacies nationwide, on adherence and reducing visits to the pharmacy.

Design: Cohort study, conducted between March 26, 2015, and December 18, 2015. Program enrollment occurred in August 2015, with a 120-day baseline period preceding enrollment and a 120-day follow-up period.

Effect of Reminder Devices on Medication Adherence: The REMIND Randomized Clinical Trial.

Importance: Forgetfulness is a major contributor to nonadherence to chronic disease medications and could be addressed with medication reminder devices.

Objective: To compare the effect of 3 low-cost reminder devices on medication adherence.

Design, Setting, And Participants: This 4-arm, block-randomized clinical trial involved 53 480 enrollees of CVS Caremark, a pharmacy benefit manager, across the United States.

Association among change in medical costs, level of comorbidity, and change in adherence behavior.

Objectives: Interventions to improve medication adherence are effective, but resource intensive. Interventions must be targeted to those who will potentially benefit most. We examined what heterogeneity exists in the value of adherence based on levels of comorbidity, and the changes in spending on medical services that followed changes in adherence behavior.

Rationale and design of the Randomized Evaluation to Measure Improvements in Non-adherence from Low-Cost Devices (REMIND) trial.

Background: Long-term adherence to prescription medications for the treatment of chronic disease remains low. While there are many contributors to suboptimal medication use, simple forgetfulness is widely believed to be central. Relatively simple devices may be a particularly cost-efficient and scalable way to promote adherence, however limited data exists about their ability to improve adherence in real-world settings.

Five features of value-based insurance design plans were associated with higher rates of medication adherence.

Value-based insurance design (VBID) plans selectively lower cost sharing to increase medication adherence. Existing plans have been structured in a variety of ways, and these variations could influence the effectiveness of VBID plans. We evaluated seventy-six plans introduced by a large pharmacy benefit manager during 2007-10.

Injectable tumor necrosis factor α inhibitors and outpatient antimicrobial use in children with rheumatic diseases: analyses of prescription claims from a pharmacy benefit manager database.

Objective: To estimate the incidence and rate of outpatient antibiotic and antiviral medication use among children receiving methotrexate and/or an injectable tumor necrosis factor α (iTNFα) inhibitor (etanercept and/or adalimumab)and to compare these rates with those of a control population.

Methods: Data were obtained from a pharmacy benefit manager (PBM) database. Children were included if they had >1 prescription claim for an iTNFα inhibitor or methotrexate prescribed by a pediatric or adult rheumatologist between 2008 and 2010 and if they were age <18 years at the time of the claim.

Methotrexate and injectable tumor necrosis factor-α inhibitor adherence and persistence in children with rheumatic diseases.

Objective: To measure adherence and persistence with methotrexate (MTX) and injectable tumor necrosis factor-α (iTNF-α) inhibitors (etanercept, adalimumab) among children prescribed these medications by a rheumatologist.

Methods: Data were obtained from a US pharmacy benefits management firm. Children were included if they were < 18 years of age, had ≥ 1 prescription claim between January 2009 and December 2010 for MTX or an iTNF-α inhibitor that was prescribed by an adult or pediatric rheumatologist.

Are caregivers adherent to their own medications?

Objective: To explore caregiver adherence to chronic medications and predictors of appropriate medication use.

Design: Descriptive, nonexperimental, cross-sectional study.

Setting: United States in May 2009.

Recent trends in the dispensing of 90-day-supply prescriptions at retail pharmacies: implications for improved convenience and access.

Background: Mail-service pharmacies offer consumers the convenience of prescriptions filled with a 90-day supply of medication. Unlike mail-service pharmacies, retail pharmacies traditionally dispensed maintenance medication prescriptions with a 30-day supply. However, the retail landscape changed in May 2008 with Walmart's announcement of an extension of its $4 Prescription Program to include 90-day-supply prescriptions.

Physician perceptions about generic drugs.

Background: With constrained health-care resources, there is a need to understand barriers to cost-effective medication use.

Objective: To study physician perceptions about generic medications.

Methods: Physicians used 5-point Likert scales to report perceptions about cost-related medication nonadherence, the efficacy and quality of generic medications, preferences for generic use, and the implications of dispensing medication samples.